Provider Demographics
NPI:1619776382
Name:KLASMEYER, CHASE MATTHEW
Entity type:Individual
Prefix:
First Name:CHASE
Middle Name:MATTHEW
Last Name:KLASMEYER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40746 MAGEE DR
Mailing Address - Street 2:
Mailing Address - City:LEONARDTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20650-2822
Mailing Address - Country:US
Mailing Address - Phone:301-771-1608
Mailing Address - Fax:
Practice Address - Street 1:40746 MAGEE DR
Practice Address - Street 2:
Practice Address - City:LEONARDTOWN
Practice Address - State:MD
Practice Address - Zip Code:20650-2822
Practice Address - Country:US
Practice Address - Phone:301-771-1608
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-13
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program